Andrea Alvalle Dentist LLC

Organization Active NPI General Practice Dentistry · Ponce, PR

NPI 1255165221 · NPPES record last updated Aug 30, 2024

Key facts

NPI
1255165221
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ANDREA ALVALLE DENTIST LLC
Practice address
1238 Ave Munoz Rivera
Ponce, PR 00717-0639
Phone
(787) 840-2153
NPI assigned
Aug 30, 2024
Organization subpart
No

Authorized official

Name
Andrea Nicole Alvalle Santiago
Title
DMD-Owner
Phone
(787) 384-4954

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240921000628 PR Part B Supplier - Clinic/Group Practice 2163963869 Receives reassigned benefits from 1 practitioner
Practice locations: Ponce, PR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

1238 Ave Munoz Rivera
Ponce, PR 00717-0639

Mailing address

1238 Ave Munoz Rivera
Ponce, PR 00717-0639
Phone (787) 840-2153

Other providers in Ponce, PR

All providers in Ponce, PR · General Practice Dentistry in Puerto Rico

Sources for this page

Verify at the official NPI Registry.